Andrew Halcro last week wrote a succinct piece on an all too common tragedy in Alaska and New Mexico.

At first glance it had all the makings of a Hollywood movie set. But this was no Hollywood movie set, it was my front yard on Sand Lake and it was 3am on June 10. For two days, fire and police vehicles were fixtures in my front yard, as the search for a missing canoeist continued. Family members gathered outside my front window, watching and waiting as they held hands, cried and prayed….

One APD officer on the scene told me that these kinds of tragedies are all too frequently due to an unfortunate combination of events. … In this case, the costliest hole was when the two young men launched their canoe at the public access point, they walked right past a newly erected life jacket stand that offered boaters free personal flotations devices.

Both NM and Alaska rank high in the USA for the prevalence of drownings (the number of deaths divided by the population). Alaska is a semi-arid region with a lot of riparian and coast line; New Mexico is a semi-arid region. Both states share a cultural norm that things go better with alcohol, especially if activities involve an engine (boat, auto, snowmachine). Both states seem to believe “accidents” [not my fault] are always happening but ones with bad consequences only happen to others, the less deserving.

PFDs (personal flotation devices, once referred to as lifevests) are no substitute for sobriety but they can buy time, if properly used. Even without alcohol present, PFDs are valuable. Take a look at these numbers–

http://dnr.alaska.gov/parks/boating/pdf/kdfschool08.pdf
1. Alaska has one of the highest boating fatality rates in the nation
a. at least 6 out of 10 are NOT wearing a life jacket
b. 9 out of 10 involve boats 26 feet and under
c. 5 out of 6 are due to capsizing or falling overboard
d. 8 out of 10 are Alaska residents
e. 9 out of 10 are adult males
f. at least 1 out of 3 involve alcohol
g. nearly all incidents involve cold water immersion

The state law allows adults to endanger themselves, but not underage children.

5. Legal requirementsa. everyone in the boat must have a life jacket of the proper size readily accessible
b. anyone under the age of 13 must be wearing a life jacket when on deck or in an open boat
c. must be suitable for the activity and wearer
1. read the label
d. must be in serviceable condition
1. free of defects (tears, missing zippers, broken buckles)
e. must be USCG-approved

PARENTS:
It’s the LAW!
Persons under the age of thirteen
MUST wear their
PFD in an open boat
or on a deck.

Alaskan 8-year old on open boat without PFD

Gov. Sarah Palin issued this proclamation in May to remind all of us that being safe around water, whether or not boating or fishing, is smart and more than the easily remembered “do what you otter around water, wear a pfd”

“WHEREAS, Alaska is blessed with an extensive coastline, millions of lakes, and thousands of rivers, making Alaska’s waters an important part of daily life; and

WHEREAS, our state offers many diverse boating opportunities for transportation, subsistence, and recreation, including kayaking, canoeing, rafting, and power boating; and

WHEREAS, boating can also be dangerous, and often fatal; and

WHEREAS, Alaska’s frigid waters can kill the unprepared, regardless of swimming ability; and

WHEREAS, four out of five of Alaska’s boating fatalities involve a sudden, unexpected capsize or fall overboard; and

WHEREAS, to help prevent accidents or fatalities while boating, boaters can take the simple step of wearing life jackets when in an open boat or on an open boat deck. In an emergency, life jackets provide an important advantage, and allow all efforts to be focused on self-rescue or getting help from others; and

WHEREAS, the newest designs make today’s life jackets more comfortable, functional, and affordable than ever. There is no reason to not wear one; and

WHEREAS, by wearing life jackets while boating, Alaskans demonstrate that when enjoying the outdoors, safety always comes first;

NOW, THEREFORE, I, Sarah Palin, Governor of the state of Alaska, do hereby proclaim May 16-22, 2009 as:

Safe Boating Week

in Alaska, and encourage all boaters to make their boating memories this season good ones by always wearing life jackets, carefully preparing for each trip, carrying appropriate communications and signaling devices, and by serving as a positive example on the water for other boaters.
Dated: May 7, 2009http://www.gov.state.ak.us/proclamations.php?id=1835

To test a life jacket, lift it at the shoulders. If the life jacket comes up over the ears, it is too big.

Test Alaska child's PFD fit. Will she slip out of unzipped PFD on open boat?

Today comes this tragic reminder of the example set “on the water for other boaters.”

A 56-year-old man drowned in Bristol Bay this morning, the Coast Guard said. He was fishing in an 18-foot skiff with his two teenage daughters when he went overboard while pulling in a net, said Coast Guard spokeswoman Sara Francis. … The accident happened in Togiak Bay around 9 a.m. and a nearby fisherman immediately called for Coast Guard help. The skiff was only 10 to 20 yards from shore but the man was not wearing a life jacket.

Avian Flu, A Pandemic & the Role of Journalists: Excerpts From a Conference From November 30 until December 2, 2006, discussion at the Nieman Foundation … “The Next Big Health Crisis — And How to Cover It” brought journalists together with scientists, public health officials, medical experts, academic researchers, law enforcement officers, public policy experts, and Homeland Security officials to talk about how best to prepare for the possible arrival of pandemic flu.

We’ve mentioned previously how important history is for understanding the science of pandemics and how people respond (good and bad examples). The folks around Seattle Washington have used history in an unusual format to present the need for preparedness and how to begin getting prepared. The comic or “graphic novel” format doesn’t trivialize the problem or the audience. Instead, it can help by removing the reader a step from the grim necessity (as a comic and as a historical dramatization) and by presenting the essence of preparation graphically, followed by resources for further study.

To promote pandemic flu preparedness, Public Health – Seattle & King County has developed a 12-page comic book on pandemic flu. Targeting readers of all ages, this story tells the tale of a family’s experience of the 1918 influenza pandemic. It also explains the threat of pandemic flu today, illustrates what to expect during a pandemic (such as school closures), and offers tips to help households prepare.

Describes a disaster preparedness training program for tribal leaders conducted in Arizona. Discusses the role of cultural competency, respect for tribal sovereignty, solicitation of historical examples of indigenous preparedness, and incorporation of tribal community networks in the success of the program.

from The Rural Assistance Center— a collaborative effort of the University of North Dakota Center for Rural Health, and the Rural Policy Research Institute (RUPRI) funded by a grant through HRSA’s Office of Rural Health Policy. All listings contained in this e-mail can also be accessed from the Rural Assistance Center Web site, Go to http://www.raconline.org/listserv/health/011708.html

The Challenges section is very important– pointing out the disadvantages of the “usual approach” to working with tribes (and why grassroots science or community-based programs would be better)

Challenges
There were several challenges to implementing the trainings in the field. These were mostly created by the very short timeline for the project due to funding restrictions. This meant there was little time to visit in the field with key stakeholders and to further encourage participation. As a result, the identification of the training participants was left almost entirely to the BT Coordinator for each tribe. Given the newness of many of these individuals to a newly created role, not all of these coordinators were well integrated into their local public health system. Some were not based within their health programs, but rather operated out of their emergency management departments. As a result several trainings had limited public health personnel participation.

Additionally the scope of the project was very broad as it encompassed all five regions within the state, and required cooperation between tribal, county and federal agency counterparts. Fragmentation within each local public health system resulted in some communication breakdowns and last minute requests.

Other challenges to participation in the training included limited resources available to the tribes. In some cases there were no travel funds for relevant personnel to attend the training session. In other instances, public health emergency preparedness and issues of bioterrorism were not considered priorities particularly compared other competing needs facing under-funded tribal health programs. Subsequently, there were several of the tribes whose BT coordinators and public health personnel were not represented at the training.

In regards to the curriculum, a “one-size fits all” approach created some challenges to meeting the needs of the audience. Due to the diverse backgrounds, roles and skills sets of the participants it was difficult to find the right pitch for all. For some it was too basic and for others too advanced. The content areas required for each module were very broad and it was difficult to present all the content comfortably in three half-day sessions.

A new Web page that addresses emergency and disaster preparedness and special populations has been added to the National Library of Medicine (NLM) Enviro-Health Links to selected Web sites featuring emergency preparedness for special populations. This includes people with disabilities, people with visual or hearing impairments, senior citizens, children, and women. Links to information in languages other than English are also provided.

Like this:

Lynne asks how old a baby can be before a caregiver (or stranger) cuts back on frequency of handwashing before touching the child.

I haven’t kept up with the latest pediatric advice. I would check with a doctor first or the university extension program, especially about a specific baby. Surprisingly, this is another topic difficult to locate specifics for implementation. I suspect the information needed (with supporting documentation) is there, just locked behind subscriptions and as an unfunded person I can’t get to it.

Lynne’s question is really about assessing risk. Here are general guidelines.

Age-related development terms are: Newborns or neonates are under 1 month old; Infants or babies are usually 3 months to 18 months; toddlers 12-2 years

Situation posed by Lynne is likely–
“Normal” or routine baby maintenance
involving some strangers and family
with or without other babies around
We aren’t talking about neonates (newborn) nor day care and play groups nor nurseries. We aren’t speaking of health care providers (who are exposed to many ill people).

In general, my guess would be 18 months is an age when others can resume everyday handwashing, certainly no sooner than 12 months or whenever infants can get around on their own (crawling or scooting). Their immune system should be in good shape then. If I remember my development biology correctly, babies get some immunity protection from their mothers for the first few months, while they switch over to their own developing system. However, getting born is a shock. Babies even experience a growth suppression then growth spurt. A lot is going on with them, so hand hygiene by others is important.

I would think there are three four main considerations–
* everyone should practice good hygiene (not excessive germ phobia) because as people we share our environment This includes keeping the living areas clean and dry.
* babies usually have pretty intimate contact with others (diapers, kissing, sharing food, sharing toys, mouthing everything) so others need to be aware of how they transmit germs to babies (don’t share chewed food or teething toys, for example)
* babies are developing their own immune systems. They need exposure to the normal environment, but intense exposure or exposure to contaminated environments can overwhelm.
* if you live in a community with an ongoing outbreak of salmonella, listeria, RSV, pneumonia, TB, norovirus, etc. and / or difficult access to clean water, then be extra vigilant with hand hygiene. see related, Give germs the boot, not our babies: unwashed hands make everyone sick

As babies get older, regular hand hygiene *by everyone* should be sufficient (by everyone is the key) for simple contact with the baby. That is, wash hands after bathroom use, after food preparation, after returning home from work, after contact sports, after petting the cow, etc.

I’m not real happy with this answer because I think it is too general. However, I’ll keep looking. I don’t really trust a lot of those new baby books either, but I don’t have access to their science to evaluate them. If anyone runs across a better suggestion, please let us know.

The Council of Canadian Academies was asked by the Government of Canada to undertake an assessment on the modes of transmission of influenza and the contribution of respirators or surgical masks towards inhibiting the spread of the virus.

Question: How and where is influenza (both seasonal and pandemic) transmitted? Based on the conclusions of this review, what is the contribution that N95 respirators or surgical masks will make in the prevention of transmission of influenza?

Kindly write to the %age proportion of Castor Oil Soap-35% being used to formulate Antiseptic Liquid Like Dettol.

I think the interest is in
* why is there soap in a disinfectant and
* why is the soap made from castor oil?

If I have failed to ask and/or answer your questions correctly please let me know. If anyone can provide additional references or a better discussion, please note in the comments.

Unfortunately, I am not an organic chemist so I can’t give great detail. But here is what I think is the short answer. The soap is used to keep the germicide (cresol or phenol) in solution until it is mixed with water for actual use (the cloudy mixed result indicates the phenol compound becoming suspended rather than dissolved). Soap is made from a fat or oil and an alkali. Castor oil has particular physical properties which make it a good molecule for making the soap to interact with the cresol/phenol molecule.

The liquid concentrate of Dettol ® and brown-bottle Lysol ® are composed of a phenol or cresol compound, alcohols, pine oil (Dettol®) and “other ingredients” which are soap, water, and caramel for coloring. When first introduced to Britain, the formula for Lysol was 50% cresol and the rest liquid soap. Lysol was so important that its commercial formula was legally established in the British Pharmacopoeia and in 1934 court standards “held that Lysol must contain 47 to 53 per cent. of cresols”. [“To use this [fake] article as a disinfectant might be worse than using none at all; its use would give a false feeling of security.” http://www.rsc.org/delivery/_ArticleLinking/DisplayArticleForFree.cfm?doi=AN9345900691 (pdf file)]

I have added below some references for further examination but in particular the chemical references or databases used for the lay term lysol, Lysol ® and Dettol ®. I have tried at the end to give the identification numbers for the compounds under discussion. These ID numbers, for example the CAS number, are unique to a chemical compound. The use is similar to the binomial scientific name used to specify which of the very many different plants in different cultures that have the same common name.

These databases can also be searched for the chemical or toxic properties of other chemicals. The Chemical Abstract Service (CAS) the 100-year old database of the American Chemical Society, is an excellent resource but only available for a fee. There is a comparable US Pharmacopoeia (USP) and a British Pharmacopoeia (BP) but perhaps someone else can locate the Internet links to these databases.

He said the gap between what public health experts know and what the public knows about pandemic planning is still very large, and more work is needed, particularly on community mitigation efforts that may be needed in a severe pandemic, such as school closures and student dismissals.

One component that seems to be missing from the HHS toolkit is a plan for distributing it to community leaders who are well positioned to use the materials, Dworkin said. “As of right now, they are available online, but who knows about them? How will community leaders, school boards, and others learn about their existence?” he asked.

Answer: readers please talk this up among your tribal councils and churches. Maybe eventually the school districts and regional hubs (such as Bethel) will get busy.

Like this:

One of the Tundra Teachers ** I read was able to take advantage of the flu shot clinic this weekend. Actually, it was the mass dispensing exercise to demonstrate disaster preparation in the region, held for the second year.

Unbelievably, the 2nd prize again this year is a pass to the “emergency shelter” which still doesn’t exist. First prize is the free shot, which this year should be an effective shot (last year it wasn’t sure the vaccines had been kept at the proper temperature so, letters were issued to come in again later. The elders who go to the senior center will get their flu shots next week, just before Thanksgiving. Elders don’t get flu shots earlier in the season, depending on how much vaccine the state sends out to us.)

I can see how someone last year must have thought it was “more authentic” to issue a pretend pass to a non-existent shelter; unacceptable but plausible. But, again? Who has the authority to declare an Infectious Disease Outbreak? Why is there a non-existent shelter for disease outbreaks and not for flooding, electrical explosion, chemical fire? What happens if a member of your family or a neighbor didn’t get a flu shot at the mass dispensing– Will they be denied access to the non-existent shelter? What if I lend my card to an elder? Can I bring my active TB?

How effective are official false hope and rumors in risk communication, preparedness, and disaster mitigation? What will you E-mail the Governor?

“Sunday, November 4, 2007
Get a Flu Shot

They were giving out free flu shots at the National Guard Armory yesterday, so Avery and I went and got one. The interesting thing about this is that once we got done with our flu shots, we received an interesting card. It’s a business card from the State of Alaska and the YKHC (Yukon Kuskokwim Health Corporation) and this is what it says….”

[Tundra Teachers** are a mix RSS feed in the sidebar here and individually at the Edublogs site So many teachers qualify this year (blogs from teachers in the Arctic and sub-Arctic) that I am behind in posting links.]

Rural_Determination_summary_KARAC_meetingbook-FINAL-www.doi.gov (pdf file) The material below is taken from the regional advisory council packets. Sections related to rural determination have …Continue reading →